Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting

Abstract

Purpose Type 2 diabetes mellitus (T2DM) self-management is a comprehensive approach that individuals with T2DM employ to manage and control their condition. Patients’ activation, “an individual’s knowledge, skill, and confidence for managing their health and health care”, has been used as a major driver of self-management. This study aimed to assess the relationship of patient activation with T2DM self-management and clinical outcomes. Design A cross-sectional study. Subjects Patients with type T2DM who age 18-years and older. Setting The primary care centers in Saudi Arabia. Measures Patient activation measure (PAM) and the Summary of Diabetes Self-Care Activities (SDSCA). Analysis Descriptive statistic, T-test, One-way ANOVA test, Chi-square test, and linear and logistic regressions were performed. Results A total of 398 patients, mostly male (54.9%) with a mean age of 53.2 (±10.7) years old participated in the study. The participants’ mean of Hemoglobin A1c (HbA1c) was 8.4% (±1.7%) and most of them (74.5%) had an uncontrolled HbA1c level (>7% %). The mean patient activation score was 55.9 (±13.5). 24.4% were at [PA1], 26.7% at [PA2], 37.4% at [PA3], and 11.5% at [PA4]. Patient activation level was positively associated with better glycemic control and self-management behaviors including diet, physical activity, blood glucose self-testing, foot care, and smoking ( P < .05) but not with adherence to medication. Conclusions Our findings reveal a positive association between patient activation level and enhanced glycemic control and self-management behaviors and suggest that patient activation-informed self-management interventions are more likely to yield promising health outcomes.